Health at a Glance: Europe 2012
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branch 1. Health status
  branch 1.1. Life expectancy and healthy life expectancy at birth

Life expectancy at birth continues to increase in European countries, reflecting reductions in mortality rates at all ages. These gains in longevity can be attributed to a number of factors, including rising living standards, improved lifestyle and better education, as well as greater access to quality health services. Better nutrition, sanitation and housing also play a role, particularly in countries with developing economies (OECD, 2011b).

Average life expectancy at birth for 2008-10 across the 27 member states of the European Union reached 75.3 years for men and 81.7 years for women (Figure 1.1.1), a rise of 2.7 and 2.3 years respectively over the decade from 1998-2010. In more than two-thirds of EU member states, life expectancy exceeded 80 years for women and 75 years for men. France had the highest life expectancy at birth for women in 2008-10 (85.0 years), and Sweden for men (79.4 years). Life expectancy was lowest in Bulgaria and Romania for women (77.3 years) and in Lithuania for men (67.3 years). The gap between EU member states with the highest and lowest life expectancies is around eight years for women and 12 years for men.

The gender gap in life expectancy at birth in 2008-10 stood at 6.4 years, around half a year less than a decade earlier. However, this hides a large range among countries, with the smallest gap in Sweden, the Netherlands and the United Kingdom, along with Iceland (about four years) and the largest in Lithuania (over 11 years). The recent narrowing of this gap in most countries can be attributed at least partly to the narrowing of differences in risk-increasing behaviours between men and women, such as smoking, accompanied by sharp reductions in mortality rates from cardiovascular diseases among men.

Looking ahead, Eurostat projects that life expectancy will continue to increase in the European Union in coming decades, to reach 84.6 years for males and 89.1 for females in 2060. Convergence among countries is expected to continue, with the largest increases in life expectancy to take place in those countries with the lowest life expectancy in 2010 (EC, 2012a).

In a context of increasing life expectancy and population ageing, healthy life years (HLY) has been endorsed as an important European policy indicator to address whether years of longer life are lived in good health (Joint Action: EHLEIS, 2012). The current leading indicator of HLY is a measure of disability-free life expectancy which indicates how long people can expect to live without disability. On average for EU member states, HLY at birth in 2008-10 was 62.2 years for women and 61.0 years for men. It was greatest in Malta for women, and in Sweden for men, and shortest in the Slovak Republic for both men and women (Figure 1.1.1). Women in Malta can expect to live 86% of life expectancy without limitations in usual activities. For men in Sweden, the value is even higher at 89%. In the Slovak Republic, only 66% of female and 73% of male life expectancy is free from activity limitation.

The spread of values for HLY at birth among EU member states are much greater than for life expectancy, being 19 years for women and 18 years for men. Since the HLY indicator has only recently been developed, there is as yet no long time series. In contrast to the 6.4 year gap in life expectancy at birth for EU member states on average, the gender gap in HLY at birth was only around 1.2 years in 2008-10. For life expectancy at birth the gender gap has always favoured women. However, seven countries had a gender gap in HLY which favoured men, the greatest being 2.0 more HLY for men in Portugal. Of the remaining countries, Lithuania had the largest gender gap in HLY favouring women. The European Innovation Partnership on Active and Healthy Ageing, part of the Europe 2020 initiative, has set an objective of increasing the average number of healthy life years by two, by 2020 (EC, 2011b).

A wide range of factors affect life expectancy and HLY. Higher national income (as measured by GDP per capita) is generally associated with higher life expectancy at birth and also with HLY, although the relationship is less pronounced at higher levels of national income (Figure 1.1.2). Similarly, Figure 1.1.3 shows that higher health spending per capita tends to be associated with higher HLY, although there is much variation for a given level of health spending, confirming that many other factors play a role in determining the number of healthy life years.

Definition and comparability

Life expectancy measures how long, on average, people would live based on a given set of age-specific death rates. However, the actual age-specific death rates of any particular birth cohort cannot be known in advance. If age-specific death rates are falling (as has been the case over the past decades), actual life spans will, on average, be higher than life expectancy calculated with current death rates.

Healthy life years (HLY) are the number of years spent free of activity limitation, being equivalent to disability-free life expectancy. HLY are calculated annually by Eurostat and EHLEIS for each EU country using the Sullivan (1971) method. The underlying health measure is the Global Activity Limitation Indicator (GALI), which measures limitation in usual activities, and comes from the European Union Statistics on Income and Living Conditions (EU-SILC) survey.

Comparing trends in HLY and life expectancy can show whether extra years of life are healthy years. However, valid comparisons depend on the underlying health measure being truly comparable. While HLY is the most comparable indicator to date, there are still problems with translation of the GALI question, although it does appear to satisfactorily reflect other health and disability measures (Jagger et al., 2010).

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1.1.1 Life expectancy (LE) and healthy life years (HLY) at birth, by gender, 2008-10 average Figure in Excel
Life expectancy (LE) and healthy life years (HLY) at
 birth, by gender, 2008-10 average
1.1.2 Healthy life years (HLY) at birth and GDP per capita, 2008-10 average Figure in Excel
Healthy life years (HLY) at birth and GDP per capita,
 2008-10 average
1.1.3 Healthy life years (HLY) at birth and health spending per capita, 2008-10 average Figure in Excel
Healthy life years (HLY) at birth and health spending
 per capita, 2008-10 average

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